Healthcare Provider Details

I. General information

NPI: 1639094261
Provider Name (Legal Business Name): CARLEE MCCRARY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4962 ELM SPRINGS RD # 1
SPRINGDALE AR
72762-3712
US

IV. Provider business mailing address

142 N BROYLES AVE
FAYETTEVILLE AR
72704-7744
US

V. Phone/Fax

Practice location:
  • Phone: 479-259-2339
  • Fax:
Mailing address:
  • Phone: 318-366-9365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5927
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: